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Compounding is "the procedure of combining, mixing, or changing substances to produce a drug customized to the specific needs of a patient." Although the FDA currently does not approve compounded medications, they are still a vital component of patient treatment plans.

Compounding is the foundation of pharmaceutical care, dating back to the days of apothecaries and patient-centered medicine. Today, compounding pharmacists and technicians expertly prepare medication dosage forms using pharmaceutical-grade chemicals and state-of-the-art equipment. Custom compounding allows for a variety of unique characteristics not commonly available in mass-produced medications. Customizations can include variables such as dosage, strength, flavor, additives, form, or routes of administration, tailored to each patient's specific needs. It also enables the creation of a variety of uniquely formulated preparations not available elsewhere.

A compounded medication has been mixed and prepared specifically for an individual patient, based on a prescription from their physician. This ability to prepare medications is a unique benefit available only to patients utilizing pharmacies like Eagle Highland Pharmacy in Indianapolis. 

The Benefits of Compounded Medications

Even if two patients have the same disease, one may receive a prescription of a different dosage or type of medication than another. The reason is that each person's body composition, functionality, and metabolic system are unique. Compounding is a pharmaceutical industry innovation that caters to the custom needs of patients.

The following are the primary advantages of compounding medications:

1. Customization & Flexibility

Many patients have distinct needs and require customized solutions to their medication-related issues. For example, numerous patients may have difficulty consuming prescribed medications. Compounding pharmacists can adjust the strength of medicine in collaboration with the prescribing physician, change its form to make it easier to administer, or add a flavor to make it more palatable.

Children and the elderly may have difficulty with the form or flavors of commercial medications. Compounding pharmacists can collaborate directly with physicians, and patients or their families, to develop a more palatable taste and further mask any unpleasant aftertaste. Compounding pharmacists can also formulate medications into liquid or cream to assist with administration when tablets or capsules cannot be easily swallowed. By altering the route of administration, patients can avoid adverse effects such as GI distress. Unique containers and devices provide numerous administration options.

Additionally, a compounding pharmacist can assist physicians in properly dosing medication for special populations based on their weight, allergies, or drug interactions.

Commonly customized medication features:

• Strength or Dosage
• Form
• Flavor
• Ingredients

2. Availability 

Products become commercially unavailable for several reasons, including decreased drug utilization or manufacturer profits. However, many of these products are the optimal treatment option for certain patients. 

Using pharmaceutical-grade chemicals and the appropriate equipment such as Eagle Highland Pharmacy’s USP 800 room and Maz machine, a specially trained pharmacist can compound medication with the same active ingredients as the unavailable product.

Similarly, as we continue to encounter supply chain challenges throughout the country, we can compound medications to ensure availability and contribute to continuing patient compliance.

3. Elimination of Allergic Components

An allergic reaction to one or more of a medicine's ingredients is a common side effect. Before compounding a medication, most pharmacies conduct an allergy test. 

Certain patients are subjected to pharmacogenetic testing to ensure that all chemical ingredients used in compounding are safe and will not cause adverse effects.

Lactose, gluten, and dyes are all common allergens. Compounding eliminates these allergens from the medication as needed so that the compounded medication significantly contributes to the patient's wellness.

Examples of Compounded Medications

For Pain Management

Compounding pharmacies can prepare the following topical and transdermal analgesics:

Local Relief   

⬜ Benzocaine 20%, Lidocaine 8%, Tetracaine 4% (Triple Pain Cream)    

 

Anti-Inflammatory    

• Diclofenac 5%, Baclofen 2%, Cyclobenzaprine 2%, Bupivacaine 1%, lidocaine 2.5%     
• Flurbiprofen 20%, Lidocaine 5%, Bupivacaine 1%, Baclofen 2%   

 

Neuropathic Pain Cream   

• Gabapentin 10%, Imipramine 3%, Bupivacaine 5%   
• Gabapentin 6%, Clonidine 0.2%, Tramadol 10%, Lidocaine 2.5%   
• Ketoprofen 10%, Gabapentin 6%, Lidocaine 5% 

   

Neuropathic and Anti-Inflammatory   

• Diclofenac 3%, Ketamine 10%, Baclofen 2%, Cyclobenzaprine 2%, Gabapentin 6%, Prilocaine 2%   
• Ketoprofen 10%, Gabapentin 6%, Baclofen 2%, Cyclobenzaprine 2%, Bupivacaine 1%, Lidocaine 2.5%   

⬜ Gabapentin 6%, Ketamine 9.2%, Ketoprofen 8%   

For Gastroenterology

1. Sodium Butyrate Suppositories

Butyrate suppositories can treat distal ulcerative colitis. They may also treat symptoms associated with other inflammatory bowel diseases, such as Crohn's disease.

2. Omeprazole Solution

Omeprazole is a proton pump inhibitor that slows gastric acid production. When contents of the stomach regurgitate into the esophagus, this condition is called gastroesophageal reflux disease (GERD).

For Obstetrics-Gynecology

Numerous compound hormones are available in capsule and pessary dosage forms for IVF specialists, as well as a variety of vaginal creams, troches, gels, and pessaries for gynecologists.

Compounded medications are available in the following delivery forms that improve compliance, reduce administration stress, and maximize the likelihood of therapeutic success:

• Gels for Topical/Vaginal Use
• Gels/Creams for Transdermal use
• Suppositories for Vaginal/Rectal conditions
• Capsules
• Topical Ointments 

These can be useful in the following cases:

• Breastfeeding issues
• Vulvodynia
• Hemorrhoids
• Atrophic Vaginitis 
• Nausea/Vomiting

For Endocrinology

1. Thyroid Supplementation

Specific T3 and T4 combinations can be made for individual patients. T3 and T4 are usually found in a ratio of 1:4, but compounding pharmacists have the ability to make ratios for any specific patient’s needs. 

We can also compound desiccated thyroid medication for patients, making sure that they get the same dose at each refill interval and not have to worry about products being out of stock. 

2. Female Hormone Replacement Therapy (HRT)

Female HRT treats menopausal symptoms and replenishes the reduced levels of hormones as menopause approaches.

Generally, patients can begin HRT as soon as they experience menopausal symptoms. There is no need to undergo any tests first.

A GP can explain the various types of HRT available and assist patients in selecting the one that is right for them.

3. Male Hormone Replacement Therapy (HRT)

Men with abnormally low testosterone levels may benefit from HRT. For instance, the condition hypogonadism can result in low testosterone levels. Compounding testosterone makes it so patients have a specific dose for their testosterone needs. 

If your doctor recommends testosterone therapy, you have several options available. These include the following:

• Rapid Dissolve Tablets 
• Lozenges/Troches
• Gels 

Why Compound at Eagle Highland Pharmacy?

Eagle Highland Pharmacy offers the highest quality compounds at the best prices. Not every compound is created equally, and that is why we have invested in the MAZ mixer, which is the most revolutionary piece of equipment in the world of compounding. The MAZ mixer’s unique planetary motion elevates product quality to the next level and keeps our practice ahead of the innovation curve. With an ingenious design, the MAZ mixer offers a wide range of innovative features and benefits that facilitate our compounding procedures while enhancing productivity. The quality is superb and the increased efficiency makes us able to pass the savings on to our customers.